Title : Acute appendicitis, appendectomy and women's fertility, state of the problem
Abstract:
Despite the fact that a number of authors point out to the direct effect of female sex hormones on the initiation of inflammation in the appendix, information about the relationships between the occurrence of acute appendicitis and the phase of the menstrual cycle is very contradictory. The anatomical connections between the appendix and the right ovary through the Clado ligament explains the generalization of infection and the possibility of hematogenous and lymphogenic spread of the inflammatory processes from the appendix to the ovary and vice versa. The intersection of the Clado ligament during appendectomy possibly leads to decline of the function of the right ovary due to a decrease in blood supply, so the risk of infertility may increase significantly. However, further researches are needed to confirm or to refute this hypothesis. According to a large number of investigations appendectomy leads to a decrease in the fertile function in women, indirectly violating the peristalsis and patency of the fallopian tubes, the mobility of their fimbriae, reduction of the secretion of glands of the mucous membrane into the lumen, leading to fibrosis of the ovarian capsule. Thus, due to the features of the anatomical structure of the female reproductive system in the case of an “acute abdomen” in women, a thorough gynecological examination is necessary to reduce the number of «unnecessary» appendectomies and to timely identify appendicular-genital syndrome. Further researches also are needed for determining the relationships between lymphatic drainage, innervation and blood supply of ileocecal region and female internal genital organs.
